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GPs lose quarter of patient lists as list-cleansing 'cock-up' blocks practices' appeals

Exclusive GPs have had up to a quarter of their patient lists removed without their knowledge in one of the most brutal list cleansing drives to date, Pulse can reveal.

Practices in Haringey, north London, have had thousands of so-called ‘ghost-patients' taken off lists by NHS Haringey as part of a cost-cutting drive. But LMC leaders claim many patients have been wrongly removed, and say they were prevented from discussing the removals with the PCT because of IT software glitches which led to patients being removed without GPs' knowledge.

It comes as PCTs increasingly move to ramp up their list-cleansing schemes in order to meet targets set by the QIPP efficiency drive, with Pulse reporting last month that nearly 40,000 patients were removed from GP practice lists in NHS Brent alone.

GPs said the latest cull has been compounded by a glitch in the computer software used to appeal against the FP69 tags applied to patients, which meant GPs were not alerted when the PCT rejected their appeal against patient removals, and only became aware when the patients had already been taken off their list.

They argued they should have been made aware so that they could try and negotiate with the PCT before the patients were removed, and warned practices are set to be penalised financially as a result.

Dr Martin Lindsay, a GP in Haringey and chair of Haringey LMC, said 1,500 patients had been removed from his practice, but estimated that only a third of these were legitimate.  

He told Pulse: ‘We have a list size of about 11,500 - 1,500 were removed, of which only 500 were legitimate.'

Dr Lindsay said GPs were dismayed they did not have a chance to discuss the removals with their PCT before they took place.

‘The PCT looks at the ones we've rejected. With the ones they disagree with, they reject our rejection, but that doesn't show on the computer system, so we are not being told. Therefore, you won't know they've been rejected until you suddenly don't see the payment.'

‘The thing is faulty. The label or code should change saying ‘please speak to the PCT', or ‘we have rejected your rejection'.

He added: ‘Not only should they be reimbursing us for those patients who have been removed erroneously, they should be paying us for this extra admin cost. It's their cock up as far as the IT is concerned, but we are being financially penalised.'

Dr Lindsay said GPs in Haringey still had time to appeal the decision, as the payments would not start applying until the next financial year. But he said any similar schemes carried out in areas that pay GPs on a quarterly basis could cause ‘real trouble'.

Dr Tony Grewal, medical director of Londonwide LMCs, said some practices in Haringey had lost more than a quarter of their patients through the latest scheme, which he said had not been agreed with LMCs. 

He said: ‘I'm aware of one practice where 500 out of a list of 1,700 were deducted.'

‘We're aware that list cleansing as a money saving exercise is part of the QIPP plans for all of London so we've been quite alert to it. But we had an undertaking that nothing new would take place without consultation. Now that has been broken.'

NHS Haringey had not responded to a request for comment by the time of publication.

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